The organization of forensic-medical examination and general problems of forensic medicine. Forensic-medical principles of examination violent and natural death Forensic Medicine – Special multidiscipline science learning and answering the medico-biological questions of low practice during investigation of criminal or civil cases. Forensic medicine (synonym: legal medicine) is a fundamental and independent part of medicine dealing with the interaction of medical science and practice with the law. Objects of Forensic medicine: - Corpse (dead bodies); - Living persons (alive persons, victims); - Material evidences of biological (blood, semen, saliva, hair etc.) and non biological origin (traumatic instruments); - Case materials (medical documents, forensic papers, investigator’s materials (metter of criminal and civil cases). Forensic medical examination (investigation) is necessarily appointed by inquest bodies in following cases: - Violent death or its suspicion. - Sudden death. - Unknown cause of death. - Death of unknown persons. - Death as a result of forbidden treatment methods by the person who does not have the right to do it. - Death in hospital: - If death is connected with violence or suspicion of it. - If the diagnosis is unascertained. - If there are complaints of the relatives on malpractice of the medical personnel. Article 75 CPC of Ukraine: «Examination is assigned when scientific, technical or other kinds of special knowledge are necessary for decision on certain investigation cases. Forensic examination – is a research by an expert on the basis of special knowledge of material objects, phenomena and processes in which there is information about circumstances of the case. Shortly it means practical activity of an expert. Article 242 CPC of Ukraine: «Examination is necessary» in the following cases: - To determine the cause of death; - To determine the degree of severity; - To determine the psychiatric status (mental condition); - To determine the sexual status of a victim; - To determine the age (as referred to criminal liability). Forensic medical examination – is the kind of forensic examination assigned to answer special medical questions which can occur in practical activity of judicial bodies or court. It is only performed under an official written sanction of an investigator or judge. Rights of forensic medical expert: - to get acquainted with the case materials; - to apply for additional resources, necessary to draw a conclusion; - to question the court, the lawyer, the accused and the witnesses; - to be present during interrogation (with the sanction of the person making inquiry); - to question the interrogated persons; - if other experts are invited for a judicial sitting, they can confer with each other and make a common conclusion; - to consult experts of all medical branches; - to receive a compensation for expertise services (in definite cases); - to refuse of examination (if the questions aren’t related to his competence, if the case materials are insufficient for investigation, if an expert does not have necessary knowledge to complete the examination). Responsibility of a forensic medical expert: According to CC of Ukraine criminal liability of a forensic expert is forecasted in the following cases: - Knowingly false testimony (Article 384). - Refusal of the expert to perform his duties (Article 385); - Disclosure of information about the investigation or inquiry (Article 387); Kinds of medico-legal examination: 1. Initial – is fulfilled firstly; 2. Additional – is carried out in cases of incomplete initial examination, also with the appearance of new data of preliminary investigation; 3. Repeated – if the conclusions of the initial examination is inconsistent or doubtful (it is performed by another expert); 4. Commission – takes place in difficult criminal cases with participation of several specialists in medical field (not only forensic-medical experts but doctors of different medical specialties can assist with the examination also); 5. Complex – is carried out with the participation of experts of different branches of knowledge (criminalists, toxicologists, technicians etc.). Initial examination is medical examination with stowage of expert deductions for its results. Primary research often is and definitive. Primeval examination can be held for one moment (research of object is deduction) and for two moments (research of object is taking of laboratory analyses, specialists consultation etc. - deduction). Additional examination is set in cases, when primary examination was incomplete, when insufficiently clearly are laid out deductions, are not reflected answers on all question of the investigator, not all of objects were explored, and also when during previous outcome are opened the new medical whether investigator data, not taken to account attached to taking of primeval examination. Expert in such cases specifies or broadens before done deductions. Additional examination is charged to the same or other expert. Repeated examination is set for settlement of the same questions and usually is bottomed on research of the same objects, that primeval examination, but takes in cases of unreasoned conclusion by expert, when primary examination was. insufficiently skilled, brings on scruples in its objectivity, loyalty, controversy to other proofs, which are in business and etc. Such examination is often charged to some other experts (commissions) and can not be taken by expert, which faced out primeval examination. For example, if primary examination on given business took by inter-district forensic medical examiner, then second is charged to regional forensic medical examiner, and etc. Commission examination – is the examination, which is taken by few experts (by commission) for settlement of the one question. Into commission enter the specialists of one profession (doctors), one or different specialities. Commission examination takes in complicated cases, when an expert can not give answer on put questions. Consequently, forensic medical examinations: 1) in businesses about attracting to criminal responsibility medical workers for professional delinquencies; 2) second, in that number for materials criminal whether civil cases; 3) on determination of degree of steady capacity loss; 4) primary in specially complicated cases –should be ought to take for participation of few experts and specialists. Commission belongs to face out also examinations of affected and artificial illnesses, suicides, members mutilation etc. Personal experts storage is determined by the bureau of forensic medical examination superior or his deputy, if such storage not promoted to investigation whether law-court. Complex - it is also commission examination, but it is taken on one business by several specialists of different knowledge industries (professions). For example, on business about car-driveway adventure complex examination can take forensic medical examiner and engineer; in case of fire wound - forensic-medical expert, expert-criminalist and forensic chemist. Under this can be one general deduction, which all of experts sign, or each specialist composes and puts name to his deduction. Complex examination isn’t foreseen by judicial norms. Structure of forensic-medical service in Ukraine. Ministry of Health Care guides medico-legal service in Ukraine. Ukrainian forensic service is based on the instance principle and submitted by a great network of the special medico-legal establishments known as the Bureaus of Forensic-Medical Examination. There are 27 forensic bureaus in Ukraine in total. Instance principle consists of 3 levels in the structure of the service. The 1st instance is formed by the experts fulfilling their duties in the towns and districts of Ukraine. The heads of medico-legal service in the regions and the major medico-legal expert of Kiev guide forensic medical service in these territories and make the 2nd instance. The Main medico-legal expert of the Ministry of Health Care guides all forensic medical service in Ukraine and represents the 3rd instance, and leads the Main Medico-legal Bureau of Ukraine as well. Every Bureau of Forensic Medical Examination consists of the following basic departments: - Department of examination of dead bodies; - Department of examination of alive persons; - Department of commission examination; - Department of examination of material evidences (forensic medical laboratory): - forensic-medical histological, - forensic-medical cytological, - forensic-medical immunological, - forensic-medical toxicological, - forensic-medical medico-criminalistic. - Department of duty forensic medical experts; - Organizational and methodical department; - Districts and interdistricts sub departments.